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NCT Number: NCT06715085

PRGF-ENDORET® Infiltrations in the Treatment of Low Back Pain.

The goal of this clinical trial is to evaluate the efficacy of PRGF in reducing pain and improving patients' quality of life. Researchers will compare an experimental drug (Plasma Rich in Growth Factors) to a control corticosteroid solution in saline solution.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Clínica Eduardo Anitua

Vitoria-Gasteiz, Alava, 01005, Spain

Location status: Recruiting

Location contact

Aitana Sainz

CONTACT

[email protected]

+35653317517

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients of legal age (≥18 years).
  • Patients diagnosed by Magnetic Resonance Imaging (MRI) with lumbar intervertebral disc degeneration(s) (Pfirrmann Scale > 1).Patients with positive signs in MRI at L4-L5 and/or L5-S1 levels, including rupture of the annulus fibrosus, annular fissure, with or without disc herniation in its protrusion form will be included.
  • Patients with low back pain with symptoms of low back pain for at least 3 months of evolution that has not responded to drug treatment.
  • Numerical pain scale (COMI PAIN SCORE): between 6 and 10, average of the last month.
  • Availability of an MRI performed in the last six months to allow the diagnosis.
  • Availability of a complete blood test (hemogram, basic biochemistry and coagulation tests) performed in the last two months.
  • Signed informed consent to participate in the clinical trial and authorization for data processing by the different centers involved for subsequent scientific publication.

Exclusion criteria

  • Patients with lumbar fracture, extruded herniated discs and herniated discs with signs of calcification are excluded.
  • Patients with severe discopathies at levels adjacent to L4-L5 and/or L5-S1.
  • Patients who have previously undergone spinal surgery.
  • Patients who have undergone invasive procedures on the spine in the last 6 months, such as infiltrations, blocks, lavage or lumbar rhizolysis.
  • Patients with neurogenic motor claudication.
  • Patients with severe cardiovascular diseases, central nervous system diseases, epilepsy, coagulopathies, immunological diseases, infectious diseases (e.g. Hepatitis B and C, HIV, Syphilis), cancer or neurodegenerative pathologies.
  • Patients with a history of drug use (e.g. alcoholism or others) and mental illness or marked psychological conditions related to pain.
  • Morbidly obese patients (BMI > 40 kg/m2).
  • Women who are pregnant or breastfeeding or women of childbearing age who are not taking effective contraceptive measures as outlined in the Clinical Trials Facilitation and Coordination Group (CTFG) "Recommendations Regarding Contraception and Pregnancy Testing in Clinical Trials" V 1.1.
  • Patients with pathologies that produce marked alterations in the efficacy of PRGF or coagulation, such as, for example: poorly controlled diabetes mellitus (glycosylated hemoglobin above 9%), hematological alterations (thrombopathy, thrombopenia, anemia with Hb < 9), being subjected to immunosuppressive and/or dicoumarinic treatments, or any treatment with systemic corticosteroids during the 6 months prior to inclusion in the study
  • Patients who present allergy to any component of the sedation or to the corticoid.
  • Patients who have received previous back treatment with PRGF in the last 6 months.

Treatment and study plan

Plasma Rich in Growth Factors (PRGF)

Drug

The PRGF application consists of three series of infiltrations in the intervertebral disc, epidural space and facets, with a frequency of two weeks.

Other names: PRGF injection

Corticosteroid solution (Celestone Cronodose suspension for injection) in saline solution.

Drug

The corticosteroid solution application consists of two series of infiltrations of solution of corticosteroid (Celestone Cronodose injectable suspension [betamethasone]) and saline solution in the epidural space and in the facets, with a periodicity of one month between them.

Other names: Corticosteroid solution

Primary outcomes

  1. To evaluate the efficacy of PRGF in reducing pain and improving patients' quality of life.

    Time frame: 6 moths follow up

    Efficacy: evaluation of the Oswestry Disability Index (ODI) (also known as the Oswestry Low Back Pain Disability Questionnaire).

    • Pain intensity / 2. Personal care (washing, dressing etc)/ 3. Lifting / 4. Walking /5. Sitting /6. Standing / 7.Sleeping /8. Sex life (if applicable)/9. Social life /10. Travelling

    For each section the total possible score is 5: if the first statement is marked the section score = 0; if the last statement is marked, it = 5. If all 10 sections are completed the score is calculated as follows:

    Example: 16 (total scored) --> 50 (total possible score) x 100 = 32% Minimum detectable change (90% confidence): 10% points (change of less than this may be attributable to error in the measurement)

    0% to 20%: minimal disability 21%-40%: moderate disability 41%-60%: severe disability 61%-80%: crippled 81%-100%: either bed-bound or exaggerating their symptoms

Secondary outcomes

  1. Percentage of treatment failures at 1, 3, and 12 months follow-up (following the definition in 8.7)

    Time frame: 1, 3, and 12 months follow-up

    Percentage of treatment failures at 1, 3, and 12 months follow-up

Other outcomes

  1. Evaluation of incidence and type of adverse events

    Time frame: Up to 56 weeks

    Safety variables: each of the adverse events will be described, with a frequency analysis of the safety variables by treatment group, and a subsequent comparison of these by means of the chi-square test.

  2. Cost-effectiveness variables

    Time frame: Up to 56 weeks

    Incremental Cost-Effectiveness Ratio (ICER). The two arms of the trial will be compared to estimate the ICER. Costs will be calculated at the individual level and prospectively.

  3. Effectiveness variable

    Time frame: Up to 56 weeks

    As a measure of effectiveness, quality of life adjusted life years (QoLs) will be calculated as a function of the duration measured by the study and the EuroQol values obtained before and at 56 weeks.

  4. Evaluation of the COMI scale.

    Time frame: 1 , 3, and 12 months of follow-up

    Evaluation of the Core Outcome Measures Index (COMI) scale. It is scored from 0 to 10, the lower the score, the better the result.

  5. Evaluation of the SF-12 scale

    Time frame: 1, 3, 6 and 12 moths follow up

    SF-12 Health Survey. This survey asks for the views about health. The result obtained depends on an algorithm. From the physical domain of the scale, the best result is 56.57 and the worst, 23.99. From the mental domain of the scale, the best result is 60.75 and the worst 19.06.

  6. Evaluation of the EQ-5D-5L Survey

    Time frame: 1, 3, 6 and 12 moths follow up

    To assess the quality of life (EQ-5D-5L survey) related to health or perceived health (in its two aspects, physical and mental). Score from 0 to 100 with 100 being the best result in terms of health.

  7. Radiological imaging (MRI) results

    Time frame: 1 year

    Differences at 12 months with respect to baseline determinations of the Pfirrmann grade

  8. Radiological imaging (MRI) results

    Time frame: 1 year

    Differences at 12 months with respect to baseline determinations of the size of the disc herniation.

  9. Radiological imaging (MRI) results

    Time frame: 1 year

    Differences at 12 months with respect to baseline determinations of the Intervertebral space height (endplate to endplace).

  10. Radiological imaging (MRI) results

    Time frame: 1 year

    Differences at 12 months with respect to baseline determinations of the disc volume.

Study contacts

Contact information is provided by the study sponsor or research team.

Aitana Sainz

CONTACT

[email protected]

+34 653 31 75 17

Sponsors and collaborators

Lead sponsor

Biotechnology Institute IMASD

Industry

Registry information

Official study title

Multicenter, Randomized, Single-blind, Controlled Clinical Trial to Evaluate the Safety and Efficacy of PRGF-ENDORET® Infiltrations in the Treatment of Low Back Pain.

Important dates

Study start
2025
Primary completion
2026
Study completion
2027
First posted
Dec 4, 2024
Registry last updated
Feb 6, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.